Francisco Raúl Sánchez-Román

Occupational Health in Mexico

Abstract This article describes the current situation of occupational health (OH) in Mexico, including socioeconomic context, legislation, health system, and educative and investigative resources, as well as the practice of OH. Workplace accidents per 100 workers decreased from 7.23 to 2.3 workers in 20 years; deaths decreased from 1.68 to 0.9 per 10,000 workers, while the occupational disease rate increased from 0.6 to 1 per 10,000 workers. This can be interpreted as an improvement in preventive measures as well as problems of recognition and registry. In Mexico OH faces challenges that range from needs for professional training and performance to needs for development of legal measures, coordination, information, and research.

El subregistro potencial de accidentes de trabajo en el Instituto Mexicano del Seguro Social

Objective. To assess the potential under-registration of work-related accidents in the Mexican Institute of Social Security. Material and Methods. A countrywide crosssectional study was carried out with information collected from 27 district offices of the Mexican Institute of Social Security (MISS), on workers seen at MISS emergency rooms during November 2001 because of a probable accident at work. We compared these reports to official records of work-related accidents to estimate the proportion of incomplete reports. Data analysis consisted of descriptive statistics for each variable; the annual estimation of incomplete reporting proportions was made by multiplying by twelve months; 95% confidence intervals were estimated using Poisson’s exact method for a proportion. Results. Data from 27 out of 37 MISS district offices revealed that 7 211 cases were not recognized as work accidents, accounting for an underestimation of 26.3%, ranging between 0 and 68% among the different district offices. The accidents that were most frequently left unregistered were mild and blunt injuries. Conclusions. Under-registration can affect worker compensation plans and the financial balance of the institution’s occupational risk insurance. Research is needed to investigate and eliminate the causes of under-registration. Employers, the industry, and health institutions should be involved in this effort. The English version of this paper is available at: http://www.insp.mx/salud/index.html

Estimation of health-care costs for work-related injuries in the Mexican Institute of social security

BACKGROUND Data on the economic consequences of occupational injuries is scarce in developing countries which prevents the recognition of their economic and social consequences. This study assess the direct heath care costs of work-related accidents in the Mexican Institute of Social Security, the largest health care institution in Latin America, which covered 12,735,856 workers and their families in 2005. METHODS We estimated the cost of treatment for 295,594 officially reported occupational injuries nation wide. A group of medical experts devised treatment algorithms to quantify resource utilization for occupational injuries to which unit costs were applied. Total costs were estimated as the product of the cost per illness and the severity weighted incidence of occupational accidents. RESULTS Occupational injury rate was 2.9 per 100 workers. Average medical care cost per case was

Panorama del subregistro de los accidentes y enfermedades de trabajo en México

2,059 USD. The total cost of the health care of officially recognized injured workers was

Seroprevalence of Pandemic A(H1N1) pmd09 Virus Antibodies in Mexican Health Care Workers Before and After Vaccination.

753,420,222 USD. If injury rate is corrected for underreporting, the cost for formal injured workers is 791,216,460. If the same costs are applied for informal workers, approximately half of the working population in Mexico, the cost of healthcare for occupational injuries is about 1% of the gross domestic product. CONCLUSIONS Health care costs of occupational accidents are similar to the economic direct expenditures to compensate death and disability in the social security system in Mexico. However, indirect costs might be as important as direct costs.

Enseñanza de medicina del trabajo en el pregrado de las escuelas de medicina en México

A nivel internacional, el subregistro—al menos de los accidentes de trabajo—se ha determinado entre 33 y 69%. En Mexico, las instancias responsables de la evaluacion de este tipo de circunstancia senalan que es de alrededor del 8%, sin embargo, a partir de diversas contribuciones realizadas dentro del sistema del Instituto Mexicano del Seguro Social (IMSS), el cual solo atiende a aproximadamente el 40% de la poblacion trabajadora del pais, se han identificado cifras de entre 26 y 78% en el periodo 1994-2004, sin tomarse en cuenta lo que respecta a enfermedades de trabajo. Bajo esta perspectiva se advierte la necesidad de ampliar la vision y certidumbre en la atencion de este problema basados en el analisis de sus causas y origenes, para finalmente delinear posibles propuestas para su contencion o eventual eliminacion, con la coparticipacion de las instituciones responsables de su registro veraz y de su atencion medica, las instancias que emiten las normas al respecto, los empresarios, y sin lugar a dudas, de los mismos trabajadores, sus gremios y los grupos organizados que los representan.

Risk factors for asthenopia among computer terminal operators

BACKGROUND AND AIMS In April 2009, a new strain of influenza A(H1N1) was identified in Mexico and in the U.S. In June 2009, WHO declared this a pandemic. Health care workers constituted a risk group for their close contact with infected individuals. The aim was to estimate seropositivity for A(H1N1)pdm09 in health staff at the Instituto Mexicano del Seguro Social. METHODS A two-stage cross-sectional study, before and after vaccination in the same workers, was performed on a random sample of health-care workers. A socio-occupational questionnaire was applied and serum antibodies against influenza A(H1N1)pdm09 were determined through neutralization of retroviral pseudotypes; two logistic regression models for both were constructed. RESULTS The average (median/mean) age of 1378 participants from 13 work centers was 41.7 years and 68.7% (947) were women. Seroprevalence for the first stage was 26.5% (365) (7.4-43%) vs. 20.8% (11) in a control group from the blood bank; for the second stage, the vaccinated group was 33% (215) (18.2-47%) and 27% (196) (11.6-50%) for the unvaccinated group. In regression models, seropositivity was associated with occupational exposure to suspected influenza infected patients, being physicians, and being vaccinated. CONCLUSIONS Seropositivity against pandemic virus is similar to what was reported, both for vaccinated (2.8-40.9%) and unvaccinated (18.8-64.7%). Low seroprevalence in the vaccinated group indicates that between 67% and 73% were susceptible to infection. Given the relatively low vaccine-induced seropositivity, it is imperative to increase, hygiene and safety for health staff and at-risk populations, and strengthen epidemiological surveillance.

Factores de riesgo para la astenopía en operadores de terminales de computadoras

Objective. To analyze the current situation of teaching occupational medicine (OM) in academic programs and medical schools in Mexico. Material and methods. A descriptive survey was conducted and schools were identified through the main directories of medical schools. For the analysis of information descriptive and inferential statistics were used. Results. A total of 75 medical schools were identified. In 39 (52%) the subject is mandatory, with a predominance in public schools (p< 0.02). Among the schools that offer the subject, only 15 (38%) have professors specialized in OM. Conclusions. Disparity in teaching basic aspects of OM in medical schools explains the little development and social and professional recognition of the specialty; it also highlights serious problems for public health, derived from the lack of prevention of risks in work environments.